Dieting and the exercise
are great, however most of the time it cannot get rid of the tummy pouch; that
results from a lifetime of weight fluctuations or pregnancy. Factors such as
multiple pregnancies and genetics can contribute to the development of loose
skin, fat deposits, and stretch marks in the abdominal region. The changes that
occur to the body – in the mid-section with one pregnancy, let alone multiple
pregnancies can contribute to a lot of damage. Sagging skin, stretch marks and
even muscle separation in the abdominal area is very common after a pregnancy.

A
tummy tuck procedure applies to both men and women alike and is one of the most
common plastic surgery procedures, as any substantial weight loss can contribute
to the development of loose skin in the abdomen. Even with proper diet and
exercise, sometimes the abdomen will appear disproportionate with the rest of
the body. The procedure can improve the appearance of excess abdominal fat,
skin and tissue in any healthy adult.

A Full Tummy Tuck
or Abdominoplasty
works by removing loose skin, fat deposits, and stretch marks from the abdominal
region. A tummy tuck cannot correct stretch marks per se, although these may be
removed or somewhat improved if they are located on the areas of excess skin
that will be excised, generally those treated areas below the belly button.

Tummy tuck procedures can be performed alone, but are often performed with
liposuction to further improve body contours. Vertical abdominal muscles that
have been stretched and weakened over time are tightened restoring a much
firmer, flatter abdomen. A full tummy tuck incision is normally made in the
shape of a “smile” that goes from hip to hip. If there is sagging skin that
extends up to or above the belly button, it can only be corrected by an
additional incision around the navel. When the skin around the navel is
released, the upper abdominal skin is pulled downward, and a new opening for the
belly button is created. The surgeons do this so that the tightened skin of the
abdominal area appears more natural.

The most important thing to remember with a tummy tuck is that it should not be
considered as a treatment for obesity, or a substitute for proper diet and
exercise. Ideally, the patient needs to be in good physical health and at a
stable weight, have realistic expectations, and preferably be a non-smoker to
undergo this surgical procedure.

Future pregnancies and substantial changes in
weight following a tummy tuck, as well as some of the scars from prior surgeries
can and do affect the longevity of the treatment. There are many plastic
surgeons that will not do this procedure on patients who have not remained
stable at their weight for more than six months.

A tummy tuck is used to correct diastatsis, a condition where the abdominal
wall muscles (rectus abdominus) have separated.The most common reason
these muscles become weakened or separated is multiple pregnancies. Many
women have some degree of this condition and don’t even know it. In some women
who have never been pregnant, there can be a ‘bulge’ in the lower abdomen (from
the belly button down) due to muscle separation that will not be closed with
exercise. Exercise tends to only strengthens the muscle. Surgery closes the
separation and flattens the abdomen.

The procedure of
abdominoplasty is done
with the skin and fat layers that lie above the abdominal wall, and they are
separated from the wall by using a cautery device. The tissue is then lifted
upward toward the rib cage to expose the abdominal muscles. To tighten the
abdominal muscles, the surgeon then will suture the abdominal muscles, pulling
them closer together, which creates a flatter, firmer abdominal wall and a
slimmer waistline.

The replacement of skin and also the new navel position is completed by
stretching the layer of skin and fat so that this is lifted away back tightly
over the abdominal wall. The navel will remain intact and attached to the
abdominal wall. It is then covered by the new layer of skin when it is pulled
back into place. The surgeon will make an incision through the layers of skin
and fat to create a new hole for your navel. The excess skin and fat that hangs
beyond the original incision line will be removed and discarded.

The incision closure for a tummy tuck will more than likely include
drainage
tubes. These drains will remain in place for approximately two to three weeks.
The incisions will be sutures and dressings and bandages will be applied.

Full Tummy Tuck
results will take several weeks into months until you see the final end outcome.
Most patients are able to return to work in one to three weeks time, however it
may take several weeks until you feel you are able to return to full normal
activity level – including heavy lifting and strenuous exercise. You will have a
permanent scar, which will fad over time. It is important to realize that if you
become pregnant or experience substantial weight gain or loss, the results from
your procedure may be compromised. Proper diet and exercise and with maintaining
your weight, this procedure (tummy tuck) can last several years.

Also know as “The Scar-less Tummy Tuck”
involves the tightening of the abdominal muscles and the removal of small
amounts of fat. No skin is removed. This is the only tummy tuck procedure that
involves no skin being removed. This procedure is minimally invasive and has a
fewer side effects, including less scarring, swelling and bruising. Also, it has
the less recovery time. The endoscopic tummy tuck is a version of the mini tummy
tuck which requires the use of an endoscope (a lighted tube with a camera on the
end of it) and scars are minimized in this procedure. Because there is less
bleeding and trauma done with this procedure, the recovery is shorter compared
to regular
abdominoplasty.

The Traditional Tummy
Tuck or Full Tummy Tuck
is mainly concerned with the flaws in the entire abdominal area both above and
below the navel. This procedure is performed under general or twilight
anesthesia, and can last anywhere from two to five hours. The traditional Tummy
Tuck is the most commonly performed surgery. Traditional tummy tucks are most
commonly combined with abdominal liposuction.

Full tummy tuck procedures
typically require two incisions. The surgeon will make an incision just above
the pubic area that spans from one hip bone to the other. The length of the
incision and its shape will depend on the extent of treatment as well as the
contours of your body. While the surgeon will attempt to place the incision so
that it is hidden by a bathing suit or undergarments, it is important to realize
that you will have a permanent scar. A second incision is usually made around
the navel. Hospital stays can depend on the extent of the surgery, anywhere from
a few hours to several days.

The plastic surgeon concentrates on the area below the navel. Patients who are
within 10 percent of their ideal body weight are the perfect candidate for this
procedure. A smaller amount of skin is removed with a mini tummy tuck, and the
navel is left intact. A mini tummy tuck is definitely less invasive than a full
abdominoplasty.
The surgeon will determine the length of the incision needed based
on the individual's own body.

The length of the incision involved in a mini tummy tuck will depend on the
amount of skin to be removed, but will subsequently be smaller than the incision
required by a traditional tummy tuck. Liposuction is commonly added with this
procedure to sculpt the area more definitively. This procedure can be performed
under both general anesthesia and or a local with sedation. However because this
procedure is less invasive, normally most patients will receive twilight or a
local with sedation.

The Extended Tummy Tuck
is an expanded abdominoplasty
procedure. The plastic surgeon removes excess skin from the patient’s sides and
improves muscle laxity at the flank (or love handles) and hip region. This
procedure is offered to those patients who have substantial weight loss and are
trying to restore the tone back into these areas. Extended tummy tucks can
remove excess skin sometimes weighing several pounds. Patients who have a
significant amount of fat and skin in the flank, upper hip, and lower back
regions are ideal candidates for this procedure. The incision goes from the
entire length of the abdominal area to the hips.

The plastic surgeon tightens
the exposed muscles and creates a new navel to match the patient’s new body
shape. Because of the extent of the surgery and the amount of tissue that was
cut away, surgeons usually require that patients remain in the hospital to
recover for at least one day. Drainage tubes are placed under the patient’s skin
to prevent the accumulation of fluid and to allow the incisions to heal
properly.

A Circumferential Abdominoplasty is
performed when there has been a massive weight-loss

(mostly commonly from
gastric bypass surgery), leaving an apron of loose skin around the entire
patient’s torso. This procedure is commonly called a Lower Body Lift. In this
procedure, the surgeon will make an incision that will extend all around the
entire waist line, in which they will remove excess skin and fat – and tighten
the muscles. The outer thighs and buttocks are lifted. Liposuction is commonly
used to re-contour the figure from the ribs to the knees.

The circumferential
tummy tuck can take as
long as three to five hours to complete, and requires a much longer recovery
period than a traditional tummy tuck procedure. This procedure can require a
hospital stay of two to four nights following the procedure, and there will be
drainage tubes to keep fluid from accumulating.

Increasing numbers of people are losing massive amounts of weight – 100 pounds
or more – with surgical assistance. But what many don’t realize is that gastric
bypass is a minor surgical procedure compared to the reconstruction some need
after losing all that weight. Excess weight stresses and stretches the skin
dramatically. Rapid weight loss does not allow skin to conform to the new body
size and shape. The result is excess hanging skin that can only be corrected
through surgical body lifts. It is not just an appearance issue for some.
Sagging loose skin may become macerated (wet and infected) if not removed,
possibly turning into a serious health problem.

After massive weight loss, even young patients with good skin quality may need a
lift. Procedures sometimes are staged over many months for comfort, health and
safety. Plastic surgeons want their patients to have a safe operation and get
through the procedure with minimal risk. The most important thing to remember is
not to expect perfection, as with any uplifting procedure there will be visible
scarring, and not all contours will be perfectly smooth, symmetrical and
proportionately balanced. But to most patients who have undergone massive weight
loss, this does not deter them. Massive weight loss patients have the ability to
accept scars where they might not have ever considered them before – simply
because they want a better shape.

A Panniculectomy is often confused with a tummy tuck – reduces excess skin and fat which hang
below the abdomen like an apron. The degree of overhang can be moderate, with
the folds hanging down to just above the public region, or much more severe;
such as low as the knees, over the hips, and around the back. A tummy tuck is
performed on people of relatively normal weight, but a panniculectomy
can be performed on patients with weight ranges from normal to severely obese,
and who have lost significant weight.

An incision is made from the lower area
below the navel to the pubic bone. Another horizontal incision is made at the
pubic area where the excess fat and skin can be removed. The skin remains is
then pulled together and closed. The reduction of excess fat and skin through panniculectomy
can greatly improve quality of life for many patients with these conditions
interfering with everyday life, such as walking, standing, or even sitting. The
health issues that are caused by this excess skin include back problems, rashes,
ulcers and many different skin disorders.

The procedure is often performed under general anesthesia and requires a
hospital stay, typically ranging from one day to one week. Insurance coverage
for the cost of the
panniculectomy varies.
If the procedure is strictly for cosmetic reasons, insurance will not cover the
procedure. However, the insurance carrier may cover all or a portion of the
costs if medical conditions are correlated with excessive weight loss.